Authors: Petrenko D.G., Sharmazanova O.P., Bortniy M.O., Evtushenko D.V.

Original full article: ]]>http://www.eurorad.org/case.php?id=11495]]>

DOI: 10.1594/EURORAD/CASE.11495

The patient arrived at the radiology department with the aim to undergo MSCT of abdomen and pelvis because of suspected neoplastic process. He had a history of weight loss during 2 months and complained of constipations and abdominal pain, and as a next step was hospitalized in the department of surgery.

MSCT was performed with intravenous bolus injection of 100 ml of iodinated contrast (3 ml/s) and parallel pneumocolon. There were no signs of colonic obstruction found. Axial scans showed a tumour of the pancreatic body with obstructive dilatation of the main pancreatic duct and side branches distal to the carcinoma, formation of small intrapancreatic pseudocysts, metastases to liver and spleen, simple bilateral renal cysts and left-sided hydroureteronephrosis caused by the renal calculus located in the left ureteral orifice. Also peripancreatic fat infiltration and lymph nodes were identified. While searching for retroperitoneal lymph nodes in paraaortic region an ovoid structure was found in axial planes with opacification during venous phase slightly lower than of inferior vena cava. Sagittal and coronal reconstructions were made and showed a tubular structure taking its origin from the left common iliac vein and ending at the left renal vein.

Differential diagnosis included lymphadenopathy and left inferior vena cava.

Final diagnosis was duplication of the inferior vena cava. Duplication of the IVC results from persistence of both supracardinal veins. The prevalence is 0.2%-3%.

There is an ovoid slightly hypodense lesion near the left common iliac artery.

There are two inferior venae cavae (right/left) on both sides of abdominal aorta. Left IVC originates from left common iliac vein, goes to paraaortic location, ends at left renal vein which joins right IVC.